ICD-10 Coding for Infusion of Rituximab-abbs(M05.79)
Complete ICD-10-CM coding and documentation guide for Infusion of Rituximab-abbs. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Infusion of Rituximab-abbs
M05-M06Primary Range
Rheumatoid arthritis and other inflammatory polyarthropathies
This range includes rheumatoid arthritis, which is a common indication for rituximab-abbs infusion.
Key Information: ICD-10 code for infusion of rituximab-abbs
Essential facts and insights about Infusion of Rituximab-abbs
Primary ICD-10-CM Code for procedure infusion of rituximab-abbs
Decision Criteria
clinical Criteria
- RF-positive serology and TNF antagonist failure
documentation Criteria
- Detailed infusion protocol and premedication documentation
Applicable To
- Rheumatoid arthritis with positive rheumatoid factor
Excludes
- Rheumatoid arthritis without rheumatoid factor (M06.9)
Clinical Validation Requirements
- RF-positive serology
- Documented failure of TNF antagonist
Code-Specific Risks
- Incorrectly coding as seronegative RA
- Omitting documentation of RF positivity
Coding Notes
- Ensure documentation includes RF positivity and prior TNF antagonist failure.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Infusion of Rituximab-abbs to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M05.79.
Impact
Clinical: Potential for adverse reactions without documented premedication., Regulatory: Non-compliance with infusion protocols., Financial: Denial of claims due to incomplete documentation.
Mitigation Strategy
Include premedication details in the infusion order, Verify documentation before submission
Impact
Reimbursement: Incorrect reimbursement due to wrong drug code., Compliance: Non-compliance with payer-specific coding requirements., Data Quality: Inaccurate data on drug utilization.
Mitigation Strategy
Verify the specific biosimilar used and code accordingly.
Impact
Incorrect coding of biosimilar drugs.
Mitigation Strategy
Verify drug name and NDC before coding.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Infusion of Rituximab-abbs, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Infusion of Rituximab-abbs
Use these documentation templates to ensure complete and accurate documentation for Infusion of Rituximab-abbs. These templates include all required elements for proper coding and billing.
Rheumatoid arthritis infusion
Specialty: RheumatologyRequired Elements
- Biosimilar name
- Dose in mg
- Infusion rate and duration
- Premedications
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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